Would like advice re weight loss stall

(Gabe “No Dogma, Only Science Please!” ) #1

Hi guys, I’ve posted around this topic a couple of times, but I need a new way to think about this. I lost over 20 pounds/~10kg in 10 weeks last year when I first went low carb. Since then, for over a year, I’ve stalled around 80-81kg and I know with certainty that I should be under 74kg.

I know many of you got into this to improve your health, and the weight loss was a nice bonus. My goals are the reverse; I’m in it for the fat loss, and having my body refuse to drop any more fat below about 80kg is really, really, really frustrating.

I’ve been cheating with sugar and carbs more and more often, partly because it feels like it makes barely any difference; the next day I’m back to low carb eating and my body simply stays the same weight.

I exercised a ton over the summer; no effect.

I’m on Metformin 1000mg for the last few weeks; no effect.

Clearly my body is somewhat insulin resistant and consistently elevated insulin levels are preventing me from shedding the rest of it. But I have no idea what I’m supposed to do at this point.

My plan is to go full keto (ie not just low carb) for the next month and see what happens. But I’m not sanguine about it.

My question is really about the psychology of it. I know @carl has been stalled for a year and others of you have reached a “set point.” I also love eating keto and don’t enjoy the feeling sugar and starches give me, so that’s a huge incentive to stay on track. But how do you think about these weight stalls? How do you not get frustrated about getting stuck with a certain amount of fat that just refuses to go?

#2

My initial question would be - why do you know with certainty that you need to be at 74kg? That seems quite low for a guy, although obviously it is variable depending on your height, etc. What body fat % would that be?

(Mike W.) #3

Have tried any fasting? Seems more effective than continuing to eat low carb.

(Gabe “No Dogma, Only Science Please!” ) #4

I dropped 20kg in 2003 and stabilized around 74kg. That was a comfortable weight even though there was probably a few more kilos of BF for me to drop to be athletic.

No idea what BF% that would be, though I could probably do the math – on 81kg my BF% is a hair above 20%. Back of the envelope calculation would have me at about 12.5% BF if I dropped to 74kg assuming all the weight loss was fat.

And I’m telling you, I can feel the difference. Big time!

(Gabe “No Dogma, Only Science Please!” ) #5

A little. I tend not to eat anything until after midday, and frequently much later than that. But I rarely go more than 22 hours without eating. It’s something I want to try – though I find it hard to believe that fasting is the only way I could get back down to my goal weight…

#6

When fasting helps folks get to their goal weight (and it often does!) it’s not the drop in eating per se, it’s that fasting is a really good way to improve your insulin sensitivity. If you think of it as a hormonal intervention, does that help?

#7

The only thing I would say is that you may need to slightly adjust expectations to allow for the fact that 14 years have passed since then! My feeling is that the best way is to drill down to keto, yes. So if you drop from your current low carb to keto. If you really want to potentially push your body fat past what your body would choose it to be then I would drop the carbs to 20g or less total (not net) and have them all come from above ground veg and a few nuts and seeds, plus the incidentals in some protein sources. Keep you fat high enough to fuel your workouts and get in a lot of interval and strength training to really go at your insulin levels. Incidentally, it would be worth testing your fasting insulin just to see if it is at a good level or not. Weight loss could easily be being hampered by that.

Make sure you also work on everything else that will feed into optimal progress - get enough sleep and good quality sleep. Address stress issues if you have them. Get some fresh air and sociable time to boost your mood.

Keep and eye on the Metformin and what happens with your BG when you drill down into keto as it could lead to your BG going too low. Talking of which… why are you on it? Presumably you have a fasting insulin, fasting glucose and HbA1c that led your doctor to start you on it?

Lastly. I don’t think a month is long enough to really give this a go, especially if you do have IR issues. Your body will need a certain amount of time to heal and correct those issues before it wants to give up that BF. I would suggest 6 months as a good amount of time to really give this a fair trial. I would also suggest switching your perspective slightly regarding your goals. If you were to make your goal optimising your health and wellbeing, my feeling is that your weight loss will follow.

This is where establishing your health markers is important. If you are insulin resistant this will indeed be a great way to get your health back up to speed and therefore also lose the weight. If you don’t already have them (which I would have thought you must to have been prescribed Metformin) I would get them - HbA1c, fasting glucose and fasting insulin. If you are IR it is ALL about getting that level down to a healthy one. It can be what tips the scales in favour when you have tried everything else. What I wouldn’t recommend though is jumping in with fasting first. Start keto and then consider fasting in a few months once you are in the swing of things.

(Gabe “No Dogma, Only Science Please!” ) #8

Oh yeah that’s exactly why I’ve been considering it, and I’m glad to hear you couch it in those terms. In fact, when I fast even for 20 or 22 hours, eating even small amounts of keto food seems indulgent. Our bodies enjoy breaks from eating, that much I’m convinced of.

Interestingly, I’ve never really been a breakfast person. Particularly when I first lost 20kg 15 years ago, I frequently wouldn’t eat till afternoon. So I’m certainly not opposed to IF as one tool to improve insulin sensitivity.

(Gabe “No Dogma, Only Science Please!” ) #9

Great comprehensive reply. You’ve hit the nail on the head: my fasting insulin was 10 when I last went home to Australia and did a Glucose Tolerance Test. My results for that test are in this thread. My doctor in Sydney who administered that test noted that my BG dropped too low at the 2 hour mark. So he suggested I be careful when starting Metformin to watch out for signs of low BG. I’ve had no ill effects thus far.

Prior to that test (back in late September), I’d gone to a weight management center here in New York. The doctor there is in favor of low carb/ketogenic diets and treats many of her patients with such dietary interventions. She was the one who first suggested Metformin on a temporary basis to help my body rid itself of the last few kg of fat – which came on very quickly back in 2003. (The 20kg weight loss was in 2002, not 2003 as I said before.) She also suggested 4 hours of exercise a week and a couple of dietary changes (including increased veggie intake.) I didn’t start the Metformin until shortly after I got back to NYC in mid-October.

I’ve had a couple of other doctors agree that Metformin is a good idea. I’m unsure and I’m willing to wait and see. Remember, that fasting insulin result of 10 was after a week of eating relatively high carb – because that’s the recommendation prior to doing a GTT. @richard noted that fasting insulin might be much higher after a period of eating high carb. Richard also said that my GTT looked to him like a healthy, insulin sensitive result. Again, I think it’s hard to tell: it’s the first GTT I’ve ever done, and the first fasting insulin test I’ve ever done, and I did it after a week on carbs. I’m considering getting my fasting insulin done whilst on low carb.

Anyway that’s the background. I think what you say makes a lot of sense: go full keto again, increase my weekly training schedule, and consider fasting – all to improve my insulin sensitivity.

My only concern is this: I went full-on ketogenic (and the test strips confirmed what I knew anyway – I was definitely in ketosis) for a couple of months over the summer. The results were grim in terms of fat loss though. Maybe I do need to add in other techniques in addition to ketosis in order to get my insulin sensitivity back on track.

I suspect a LOT of people are in my situation and I’ve been increasingly frustrated over the past few months because it’s not just difficult to shed these last few kilos; it seems almost impossible!

#10

I would say that yes, it is likely you need to do a combination of things. One of those will be to apply patience as frustrating as it is! My advice would be to absolutely focus on getting that insulin down because I think everything else will follow that. That, IMO, needs to be your main goal. I wouldn’t necessarily increase your exercise regime (unless you want to) but rather change it to do things that are known to impact favourably on insulin and BG. If you re happy skipping breakfast then exercising in a fasted state will also likely help too. BUT please keep a very good eye ion your BG in the context of the Metformin and have something handy that can bring your BG back up if needs be - something low carb and fatty like a nut butter. Enough carbs to raise it but not so much as to spike and crash.

Seriously address the other things like sleep and stress though if they are lacking. So many people underestimate the impact they have on weight.

(Gabe “No Dogma, Only Science Please!” ) #11

I’m working on my sleep – it’s a challenge. My stress levels are ok.

I’m not testing my BG; how can I know if I’m in trouble whilst on the Metformin? Will I feel it?

#12

I would say the potential impact would be that your BG would go low - a bit too low. It just struck me that if you were exercising fasted that it might just drop a bit low and make you feel woozy etc. @richard would have a more reliable opinion on this as he has experience of keto and Metformin together. I am simply hypothesising!

(Deb) #13

A couple things that helped me ( besides fasting, which absolutely did):
Cut out the extra fat. Your body can’t and won’t utilize your stored body fat if you are overeating fat. For example, I have a cream cheese addiction. And almond butter. Ok. AND whipped cream! If and when I eat these, I will pack on the pounds.
As you get close to goal, you have to be more careful.

#14

We’re talking 6 kg, that’s not much. If you just want the weight gone ASAP, another option is do an extended fast. Just don’t eat until the weight is gone. From your profile pic, you’re a youngish male. You could shed that in a 21 day fast. Its extreme, but it’s effective.

(Mike W.) #15

All those things you listed have relatively high carbs. I don’t think it’s the fat.

(Deb) #16

Pretty much all 0 or very low carb all. And I make my own almond butter (though not very well!)

(Gabe “No Dogma, Only Science Please!” ) #17

Interesting point. Though I think there is something to the idea that we don’t need to be eating 80-90% fat calories if we’re carrying a lot of body fat. To the outsider, our diet should probably look relatively high in protein, whilst inside our body is burning body fat as a substantial part of our fuel mix. Right?

For this reason, I think you bring up an interesting point. I’m not a calorie or carb counter, but I do wonder what my macros would look like once I’m back in fat burning mode. I suspect they’d be even lower in carbs than they are now, somewhat lower in fat, and somewhat higher in protein…

(Gabe “No Dogma, Only Science Please!” ) #18

Well almonds and cream cheese do have more carbs that I’d like! I think that’s the point he was making.

(Mike W.) #19

Take a look at this. I disagree with most people here about how much protein we need because I agree with Dr. Fung who says we need much less than any calculator will tell you.

(Karl Bork) #20

I’ve read that eating nothing but ground beef with butter can break a stall, although I have not tried it myself.